A Comparative Study On The Therapeutic Effect Of Non-pharmacological Interventions In Parkinson’s Patients-A Bayesian Network Meta-analysis

In this study,Bayesian network Meta-analysis was used to evaluate and rank the efficacy of various non-pharmacological interventions for the treatment of Parkinson’s patients,in order to provide evidence-based basis for selecting the best non-pharmacological intervention methods in nursing practice.An exhaustive literature search was conducted based on CNKI,CBM,VIP,the Wanfang database,Pub Med,Embase,the Cochrane Library and other databases,and randomized controlled trials(RCTs)about non-pharmacological therapy for elderly adults with Parkinson’s disease were identified from their inception to January 15,2021.The literature was screened according to the research purpose and the predefined inclusion and exclusion criteria,and the literature was managed by Endnote.After data extraction,the bias risk assessment tool in Review Manager(Version5.4)was used to evaluate the quality of the included literature,then I selected statistics and appropriate statistical model to do statistical inference,and used Review Manager to draw forest plots and funnel plots for each subgroup.The funnel plots were used to determine whether there was publication bias in the literatures.Then I used R(Version3.5.3)and GEMTC to draw the trajectory map,density map and Brooks-Gelman-Rubin diagnostic map to diagnose the degree of convergence of the model.Besides,the intervention efficacy of each intervention was ranked by rank probabilities and rankogram.Overall,3556 citations were identified through our initial search and only 56 were finally included our in our Bayesian network Meta-analysis.The results of network Meta-analysis revealed that,compared with the control group,the four non-drug interventions had better improvement effect on Parkinson’s patients: The results of the Meta-analysis showed that compared with the control group,the four non-drug interventions had better improvement effect on Parkinson’s patients: effective rate of moxibustion in treating Parkinson’s disease(RR=1.30,95%CI: 1.15-1.47,P < 0.0001),effective rate of acupuncture in treating Parkinson’s disease(RR=1.20,95%CI:1.11～1.30,P < 0.00001),the efficacy of low frequency transcranial magnetic stimulation based on UPDRS score in the treatment of Parkinson’s disease(MD=-4.89,95%CI:-6.25 to-3.54,P < 0.00001),the efficacy of high frequency transcranial magnetic stimulation based on UPDRS score in Parkinson’s disease(MD=-4.86,95%CI:-6.50 to-3.22,P < 0.00001),deep brain stimulation based on UPDRS score in the treatment of Parkinson’s disease(MD=-7.63,95%CI:-8.92 to-6.33,P < 0.00001).The convergence degree of the model in this study was perfect,and the order of the intervention measures was electric stimulation of subthalamic nucleus deep brain,moxibustion,transcranial magnetic stimulation,acupuncture,and control intervention.The results of our Bayesian network Meta-analysis based on the data in this study revealed that using moxibustion or acupuncture alone or combined with western medicine in the treatment of Parkinson’s patients is better than the control group in terms of total effective rate and significant efficiency,respectively.High and low frequency transcranial magnetic stimulation or deep brain stimulation of the subthalamic nucleus in the treatment of Parkinson’s patients is better than the conventional treatment group in terms of overall efficacy and motor function.The order of intervention measures based on the data in this study is electric stimulation of subthalamic nucleus deep brain,moxibustion,transcranial magnetic stimulation,and acupuncture.